Exploration of the relationship between Graves' eye disease and type 2 diabetes based on biomarkers.

Purpose: The development of Graves' ophthalmopathy (GO) is silent and can be accompanied by type 2 diabetes (T2D). However, the early diagnosis of these two conditions remains difficult.

Methods: We evaluated a total of 123 patients with T2D and GO and 128 patients with GO treated in our hospital from 01 May 2016 to 31 May 2022. We determined the levels of several biomarkers and developed a regression model to evaluate the diagnostic efficacy of these biomarkers.

Results: Univariate analysis showed that age and thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), glycated haemoglobin (HbA1c), and fasting glucose levels were significantly different in the GO-T2D group compared with the GO group. In the multivariate logistic regression analysis, FT3 and FT4 levels lost their statistical significance when the other factors remained unchanged. Older age and higher TSH, HbA1c, and glucose levels were associated with an increased likelihood of having GO-T2DM. The regression model for diagnosing GO and GO-T2D presented an R² of 0.70, a sensitivity of 87.80%, a specificity of 93.75%, and an area under the receiver operating characteristic (ROC) curve of 0.97.

Conclusion: Age and TSH, HbA1c, and glucose levels are effective predictors of GO and GO-T2D. Therefore, routine examination of these biomarkers in patients with GO could help to diagnose T2D early, thus allowing early treatment and a better prognosis.